The Mountain of Hope Organization

THE MOUNTAIN OF HOPE ORGANIZATION

OF

MOUNT HOPE, WEST VIRGINGA

Bringing More Hope to Mount Hope & West Virginia

The Mountain of Hope Organization

Educational Scholarship Application Form

Post Office Box 323 |Mount Hope, W.Va. 25880

An Equal Opportunity Institution

Visit Our Web Site at:

______

Award: $1,500 will be awarded to applicants for the 2012-2013 school year

Application Deadline: March 31, 2013

Eligibility Requirements

- Currently a graduating high school senior or a post-secondary student

- High school or post-secondary grade point average of 2.5 or above

- Citizen or permanent resident of the United States

- Pending acceptance to a post-secondary institution (required for receipt of scholarship)

- Agreement to attend the Mount of Hope meeting to accept any award or send an

appropriate designee (parent, exec. Dir. of the project/program, foster parent, etc.)

- Scholars should be willing to update the Mount of Hope about their experience

- May not be an immediate relative of the Mount of Hope member (i.e. Sibling, daughter, son)

- Scholars must use the funds awarded within one calendar year from the official award date

Scholarship Award Application: Applicants must submit the following information for scholarship consideration:

- Completed application form

- High school and/or any post-secondary school transcripts

- Letter of recommendation from academic advisor, academic counselor or recent instructor

- A second letter of recommendation from an individual not related to you

Please submit all of the above items in a single envelope postmarked by March 31, 2013 to:

The Mountain Of Hope Organization

Scholarship Committee

PO Box 323

Mount Hope, West Virginia 25880

(Page 1 of 4)

(Please Print or Type Clearly)

I.Personal Information

A.Contact Information

Name: ______

e-mail (if applicable): ______

Address: ______

Home Phone: ______Cell Phone: ______

Are you a U.S. citizen or permanent resident? Yes______No______

B.Other Contact (Parent, foster parent, etc. who know how to contact you if the above

Information changes)

Name: ______

e-mail (if applicable) ______

Address: ______

Home Phone: ______Cell Phone: ______

II.Educational Background

Name / Address / Dates Attended / Date of Graduation
High
School / ____/____/____
to
____/____/____
College / ____/____/____
to
____/____/____
Vocational
School / ____/____/____
to
____/____/____

(Page 2 of 4)

III.Future Education Plans

A.Schools Applied To

1st Choice: ______

Address: ______

Accepted yet: yes / no / pending

2nd Choice: ______

Address: ______

Accepted yet: yes / no / pending

Proposed course of study/major: ______

Full-time or part-time status: Full-time______Part-time______

B. In the space provided or on a separate page, please describe your future school and career

plans (not to exceed a half page.)

C.In the space provided or on a separate page, please describe your greatest challenge,

how you faced it and how it affected you (not to exceed one page).

(Page 3 of 4)

IV.Employment and Volunteer History

A.Current Employer

Employer / Address / Contact Name / Telephone No. / Dates Worked / Hours Per Week
____/____/____
to
____/____/____

B.Other Employment, Volunteer or Relevant Experience

Employer / Address / Contact Name / Telephone No. / Dates Worked / Hours per
Week
____/____/____
to
____/____/____
____/____/____
to
____/____/____
____/____/____
to
____/____/____

C.In the space provided or on a separate page, please describe any personal growth or learning

experience that resulted from participation in any of the above activities (not to exceed one

page).

(Page 4 of 4)

V.Mountain of Hope scholarship information

A.Please indicate how you learned about Mountain of Hope scholarship awards.

B.Have you received a Mountain of Hope scholarship award in the past? If yes, for what?

I certify that the information provided in this application is honest and true.

______/____/____

Name (Please print)SignatureDate

______/____/____

Signature of parent or Guardian if applicant is under 18 years of ageDate

Thank you for completing the Mountain of Hope Scholarship Application. The members of the MOHO share a vision of a community in which the health, safety, and education of all individuals are promoted and supported. The members of the MOHO share a vision of the organization in which the experience, knowledge, and leadership skills of all members are promoted and supported.